Page 1 of 3 DUII Diversion Form 4 Revision 2/2019 IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR WASHINGTON COUNTY State of Oregon Case Number : v . PETITION TO PLEAD GUILTY OR NO CONTEST DUII Diversion and Reckless Driving Defendant 1. My true name is (if different) , I am also known as . 2. I am years old. The highest grade level of school I have completed is. 3. My physical and mental health is presently satisfactory. I am not under the influence of any drugs or intoxicants, except: . 4. The following statement best describes me: I am able to read, write, and understand English, and I have read this petition completely I am able to understand English, and this petition has been read aloud to me completely I am unable to read English, and this petition has been read aloud to me completely in English I am unable to read, write, or understand English, and this petition has been read aloud to me in the language by , who is qualified to translate English into the language. 5. I am am not represented by a lawyer. I understand that I have the right to hire a lawyer or have the court appoint a lawyer to represent me if the court finds that I cannot afford to hire a lawyer. I choose to give up my right to a lawyer. I will represent myself. () [initial here] 6. If represented by a lawyer, I have told my lawyer all the facts I know about the charge against me. My lawyer has advised me of the nature of the charge and the defenses, if any, that I have in this case. I am satisfied with the advice and help my lawyer has given me. 7. I understand that I have the following rights: a) the right to jury trial; b) the right to confront and question all witnesses who testify against me at trial; c) the right to remain silent about all facts of the case; d) the right to subpoena witnesses and evidence in my favor; e) the right to have my lawyer assist me at trial; f) the right to testify at trial; g) the right to have the jury told, if I decided not to testify at trial, that they cannot hold that decision against me; and h) the right to require the prosecutor to prove my guilt beyond a reasonable doubt. 8. I understand that I give up all of the rights listed in paragraph 7 when I plead guilty or no contest. I understand I give up: a) any defenses I may have to the charge; b) objections to evidence; and c) challenges to the accusatory instrument. 9. By this petition, a. I am pleading guilty no contest to the crime of Driving Under the Influence of Intoxicants (DUII) which is a Class A misdemeanor under Oregon law. The maximum penalties applicable if I fail to comply with the conditions of diversion are: 364 days in jail and a fine of $6,250 or $10,000 if the offense was committed in a motor vehicle and there was a passenger younger than 18 and at least three years younger than me. The minimum penalties are 48 hours of imprisonment or 80 hours of community service, a mandatory suspension of my driving privileges for at least 1 year and a fine of $1,000 if this is my first conviction, a fine of $1,500 and a 3 year suspension of my driving privileges if this is my second conviction, a fine of $2,000 and a lifetime suspension of my driving privileges if this is my third conviction and I am not sentenced to a term of imprisonment or $2,000 if my blood alcohol level (BAC) was 0.15 percent or greater. b. I am pleading guilty no contest to the crime of Reckless Driving which is a Class A misdemeanor under Oregon law. In addition to the above penalties; If I fail to comply with the conditions of diversion, a mandatory suspension of my driving privileges will be imposed for 90 days if this is my first conviction, a 1 year suspension of my driving privileges if this is my second conviction or a 3 year suspension of my driving privileges if this is my third or subsequent conviction. American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 3 DUII Diversion Form 4 Revision 2/2019 10. I understand that if I am not a U.S. citizen, this plea may result in my removal from this country, exclusion from admission to the United States, or denial of naturalization. 11. I understand that I will be required to pay all of the fees listed in the Summary of DUII Diversion Fees, unless the court finds me unable to pay and waives all or part of these fees. These fees include an alcohol or drug abuse assessment and any recommended treatment and a separate Reckless Driving fee if applicable. The court may order me to attend a victim impact panel and pay a participation fee. I may be required to reimburse the state for the cost, if any, of a court-appointed attorney. 12. I am submitting this plea along with a petition to enter the diversion program under ORS 813.200 to 813.270. I understand that if the court grants the petition, the court will accept this plea but will not enter a judgment of conviction at this time. 13. I understand that: a. If I fully comply with the conditions of the diversion agreement within the period authorized by law and by the court, the court will dismiss the charge(s) with prejudice under ORS 813.250. Evaluation Services will submit a dismissal request on my behalf and the court will monitor and dismiss Reckless Driving charges if applicable. b. If I fail to comply with the diversion agreement within the diversion period, the court will enter a judgment of conviction on the charge (s) and will sentence me. 14. I understand that if the court enters judgment on this plea for failing to comply with the diversion agreement, it is the same as a conviction. This court can find me guilty of the crime of DUII and Reckless Driving based on this plea alone, without receiving any evidence. 15. I understand that if the court denies the diversion petition and I go to trial, nothing in this petition will be used against me. 16. This plea is based only on what is written on this petition. No promises have been made to me by my lawyer or any officer or agent of any branch of government (federal, state, or local) that I will receive a particular sentence or form of treatment from this or any other court, on these or any other charges, other than what is set forth in this petition. 17. I am pleading guilty because in Washington County, Oregon, I did the following: Or I am pleading no contest. 18. I am am not currently on probation, parole, or post-prison supervision. I know that if I am and the court enters judgment on this plea, my failure to comply with the conditions of the diversion agreement may cause my probation, parole, or post-prison supervision to be revoked and I may be required to serve jail or prison time in that case in addition to any sentence imposed in this case. 19. I understand the charge(s) against me and the information in this petition. I am signing this petition and entering this plea voluntarily, intelligently, and knowingly. 20. I understand that if I fail to comply with the terms of the diversion and the court enters a judgment of conviction, I have the right to appeal the conviction. My right to an appeal will be explained to me when the court enters the judgment of conviction. Certificate of Document Preparation Check all that apply: I chose this form for myself and completed it without paid help I was assisted by the DUII Advisory Counsel I was assisted by a court appointed attorney A legal help organization helped me choose or complete this form, but I did not pay money to anyone I paid (or will pay)for help choosing, completing, or reviewing this form Defendant222s Signature Defendant222s Name (printed) Date American LegalNet, Inc. www.FormsWorkFlow.com Page 3 of 3 DUII Diversion Form 4 Revision 2/2019 CERTIFICATE OF COUNSEL I am the attorney for the defendant in this proceeding and I certify that: 1. I have fully explained to my client the charge and possible defenses that may apply in this case 2. I have personally examined this plea petition, explained all of its provisions to my client, and discussed fully with my client all matters described and referred to in the petition 3. I have explained to my client the maximum penalty and other consequences of entering a guilty or no contest plea, including possible immigration consequences 4. To the be